FREDERICK J FAGAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926252

License Status

NOT RENEWED

Business

First Name

FREDERICK J

Last Name

FAGAN

Suffix

Business Name

FREDERICK J FAGAN OD

Original Issue Date

06/09/1999

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/11/2005